Shams S, Martola J, Cavallin L, Granberg T, Shams M, Aspelin P, Wahlund L O, Kristoffersen-Wiberg M
From the Department of Clinical Science, Intervention, and Technology, Division of Medical Imaging and Technology (S.S., J.M., L.C., T.G., M.S., P.A., M.K.-W.) Department of Radiology (S.S., J.M., L.C., T.G., M.S., P.A., M.K.-W.)
From the Department of Clinical Science, Intervention, and Technology, Division of Medical Imaging and Technology (S.S., J.M., L.C., T.G., M.S., P.A., M.K.-W.) Department of Radiology (S.S., J.M., L.C., T.G., M.S., P.A., M.K.-W.).
AJNR Am J Neuroradiol. 2015 Jun;36(6):1089-95. doi: 10.3174/ajnr.A4248. Epub 2015 Feb 19.
Cerebral microbleeds are thought to have potentially important clinical implications in dementia and stroke. However, the use of both T2* and SWI MR imaging sequences for microbleed detection has complicated the cross-comparison of study results. We aimed to determine the impact of microbleed sequences on microbleed detection and associated clinical parameters.
Patients from our memory clinic (n = 246; 53% female; mean age, 62) prospectively underwent 3T MR imaging, with conventional thick-section T2*, thick-section SWI, and conventional thin-section SWI. Microbleeds were assessed separately on thick-section SWI, thin-section SWI, and T2* by 3 raters, with varying neuroradiologic experience. Clinical and radiologic parameters from the dementia investigation were analyzed in association with the number of microbleeds in negative binomial regression analyses.
Prevalence and number of microbleeds were higher on thick-/thin-section SWI (20/21%) compared with T2*(17%). There was no difference in microbleed prevalence/number between thick- and thin-section SWI. Interrater agreement was excellent for all raters and sequences. Univariate comparisons of clinical parameters between patients with and without microbleeds yielded no difference across sequences. In the regression analysis, only minor differences in clinical associations with the number of microbleeds were noted across sequences.
Due to the increased detection of microbleeds, we recommend SWI as the sequence of choice in microbleed detection. Microbleeds and their association with clinical parameters are robust to the effects of varying MR imaging sequences, suggesting that comparison of results across studies is possible, despite differing microbleed sequences.
脑微出血被认为在痴呆和中风中具有潜在重要的临床意义。然而,同时使用T2*和SWI磁共振成像序列检测微出血使得研究结果的交叉比较变得复杂。我们旨在确定微出血序列对微出血检测及相关临床参数的影响。
来自我们记忆门诊的患者(n = 246;53%为女性;平均年龄62岁)前瞻性地接受了3T磁共振成像检查,包括传统厚层T2*、厚层SWI和传统薄层SWI。由3名具有不同神经放射学经验的评估者分别在厚层SWI、薄层SWI和T2*上评估微出血情况。在负二项回归分析中,分析痴呆调查中的临床和放射学参数与微出血数量的相关性。
与T2*(17%)相比,厚层/薄层SWI上微出血的患病率和数量更高(20/21%)。厚层和薄层SWI之间的微出血患病率/数量没有差异。所有评估者和序列的评估者间一致性都非常好。有无微出血患者之间临床参数的单变量比较在各序列间没有差异。在回归分析中,各序列间与微出血数量的临床相关性仅存在微小差异。
由于微出血检测率的提高,我们推荐SWI作为微出血检测的首选序列。微出血及其与临床参数的关联对不同磁共振成像序列的影响具有稳健性,这表明尽管微出血序列不同,但跨研究结果的比较是可行的。